Wang Jian-an, Xie Xiao-jie, He Hong, Sun Yong, Jiang Jun, Luo Rong-hua, Fan You-qi, Dong Liang
Department of Cardiology, Sir Run Shaw Hospital, Zhejiang University, College of Medicine, Hangzhou 310016, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Feb;34(2):107-10.
Recent experimental and clinical observations have suggested that cell transplantation could be of therapeutic value for the treatment of heart failure. This study was performed to explore the efficacy and safety of intracoronary autologous mesenchymal stem cells (MSCs) transplantation for treating patients with idiopathic dilated cardiomyopathy.
Twenty-four consecutive patients with idiopathic dilated cardiomyopathy received standard drug therapy were randomly divided into intracoronary injection of autologous mesenchymal stem cells (treated, n = 12) or saline (control, n = 12) groups. Serum IL-6, TNF-alpha and CRP, plasma brain natriuretic peptides (BNP) were determined and echocardiography, Holter electrocardiogram monitoring and six minutes walk test were performed at baseline, 3 and 6 months post injection.
IL-6, TNF-alpha and CRP remained unchanged after MSCs transplantation. Plasma BNP levels at 3 months and 6 months post MSCs injection were significantly higher than that of pre-injection (378.10 +/- 147.47, 420.40 +/- 148.50 vs. 292.40 +/- 148.54 ng/L, respectively, P < 0.05) but were significantly lower than that in control group at comparable time points (3 months: 378.10 +/- 147.47 vs. 473.10 +/- 106.31 ng/L; 6 months: 420.40 +/- 148.50 vs. 544.60 +/- 93.11 ng/L, P < 0.05). Six-minute-walking distance significantly increased at 6 months after MSCs injection compared with pre-injection level and which is also higher than that in control patients (519.00 +/- 43.28 vs. 396.33 +/- 42.19 and 464.00 +/- 76.5 m, respectively, P < 0.05). Left ventricular ejection fraction and LVEDd remained unchanged post MSCs injection. No malignant arrhythmias and severe side effects could be observed around transplantation and during six months follow-up. Survival was similar between the two groups during six months follow-up.
Percutaneous coronary autologous mesenchymal stem cells transplantation can attenuate the increase of plasma BNP, increase six-minute-walking capacity in patients with idiopathic dilated cardiomyopathy.
近期的实验和临床观察表明，细胞移植可能对心力衰竭的治疗具有治疗价值。本研究旨在探讨冠状动脉内自体间充质干细胞（MSCs）移植治疗特发性扩张型心肌病患者的疗效和安全性。
24例接受标准药物治疗的特发性扩张型心肌病患者被随机分为冠状动脉内注射自体间充质干细胞组（治疗组，n = 12）和生理盐水组（对照组，n = 12）。在基线、注射后3个月和6个月时测定血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP），进行超声心动图、动态心电图监测和六分钟步行试验。
MSCs移植后IL-6、TNF-α和CRP保持不变。MSCs注射后3个月和6个月时血浆脑钠肽（BNP）水平显著高于注射前（分别为378.10±147.47、420.40±148.50 vs. 292.40±148.54 ng/L，P < 0.05），但在相应时间点显著低于对照组（3个月：378.10±147.47 vs. 473.10±106.31 ng/L；6个月：420.40±148.50 vs. 544.60±93.11 ng/L，P < 0.05）。MSCs注射后6个月时六分钟步行距离较注射前显著增加，且高于对照组患者（分别为519.00±43.28 vs. 396.33±42.19和464.00±76.5 m，P < 0.05）。MSCs注射后左心室射血分数和左心室舒张末期内径保持不变。在移植期间和六个月随访期间未观察到恶性心律失常和严重副作用。两组在六个月随访期间的生存率相似。
经皮冠状动脉自体间充质干细胞移植可减轻特发性扩张型心肌病患者血浆BNP的升高，增加六分钟步行能力。
